Human resource issues in cytotoxic drug dispensing

Abstract

Introduction. The human resource issues for phar macists manipulating and dispensing cytotoxic drugs in safety cabinets and clean rooms, in accordance with Australian Standards, have been investigated. The technology is regulating, resulting in very formal procedures and work practices. Often staff work under conditions of restricted environmental stimula tion that can have effects on cognitive functioning and reduce efficiency for demanding tasks. Methods. Discussions were held with senior staff of twenty hospitals treating patients with cancer, one manufacturing facility, and one research laboratory, regarding work in cytotoxic drug suites. A survey was administered to staff working in these facilities. Issues explored included: work practices; rosters; cleaning; work flow; ergonomics; quality of work environment; clothing; certification of facilities, and training. Results and Discussion. The survey shows that the major stressors for people working in the facilities are the physical conditions, especially the tempera ture, and the lack of control over workflow. It confirms the importance of windows in the working environment and the need for communication facili ties. Design deficiencies in the technology that impact the quality of the work environment are identified. There are age differences with regard to perceptions of risk from cytotoxic drugs. The study identifies the need for further training, both in technique and understanding of the technology. Conclusion. Whilst minimising risk to staff, the adoption of the technology has had an impact on environment. Identification of these issues should enable improved facilities and work environment.

Penetration and splash protection of six disposable gown materials against fifteen antineoplastic drugs

“…The authors concluded that comfort as well as other important human resources issues should be considered in the management of facilities preparing antineoplastic drugs. 18 Choosing the most protective gown material from this group will not ensure protection if preparers do not wear the CPC properly.…”

“…9 -14 Also, as protective garment materials increase in thickness or evaporative resistance, heat exchange by sweat evaporation is impeded, increasing physiological strain and general discomfort. [15][16][17][18] This may lead to noncompliance with proper CPC use despite adequate protective properties of the garment material. 19,20 Testing the protective properties of a CPC involves specific tests for both penetration and permeation.…”

Safe handling of hazardous drugs

“…51 Do not purge air from the needle before administration. It is strongly recommended that oral hazardous drugs be handled in a manner that avoids skin contact, liberation of aerosols or powdered medicine into the air and cross-contamination with other 52 medicines. It is strongly recommended that solid oral preparations (tablets) of hazardous drugs be crushed or cut within the BSC.…”

“…It is strongly recommended that oral hazardous drugs be handled in a manner that avoids skin contact, liberation of aerosols or powdered medicine into the air and cross-contamination with other 52 medicines.…”

“…Discard bag with attached tubing into an appropriate waste container as a single unit. It is legislated that safety-engineered needles be used as per Needle Safety Regulation 474/07 made under the Occupation Health and Safety Act Labour, 2010. 51 Do not purge air from the needle before administration. It is strongly recommended that oral hazardous drugs be handled in a manner that avoids skin contact, liberation of aerosols or powdered medicine into the air and cross-contamination with other 52 medicines. It is strongly recommended that solid oral preparations (tablets) of hazardous drugs be crushed or cut within the BSC. If patients are unable to take in the solid format, it is strongly recommended that the pharmacy provide these drugs in an oral syringe or dissolve and dose container, in a ready-to-administer, liquid oral form. It is strongly recommended that the application of topical hazardous drugs be done using appropriate PPE and in a way that prevents contamination of the environment.…”